Intra-articular acetabular osteochondroma in patients with multiple hereditary exostoses.

Abstract

We report three additional cases of intra-articular acetabular osteochondroma in multiple hereditary exostoses patients in order to raise the awareness of this rare location, to prompt early diagnosis, and to present various treatment options according to the patient's condition. A 2.5-year-old boy presenting with an out-toeing gait had a large acetabular osteochondroma causing lateral displacement of the femoral head and acetabular dysplasia. Mass excision through hip subluxation via anterior approach and concomitant Dega osteotomy resulted in a congruent, well-developed, and well-covered hip joint at 11-year follow-up. A 10-year-old boy showing a pedunculated osteochondroma arising from the triradiate cartilage was successfully treated by arthroscopic excision. Normal development of the hip joint was observed at skeletal maturity. A 6-year-old boy presented with a painless limp. Acetabular osteochondroma could be confirmed by computed tomography scan, which was excised through hip subluxation by anterior approach. Persistent coxa valga and femoral head uncovering were addressed by femoral varization osteotomy at 9 years of age. A high index of suspicion is required to detect a lesion at this rare location. Various procedures may be considered according to the pathoanatomy. Acetabular dysplasia, coxa valga, and femoroacetabular impingement by femur neck mass, if associated, should be addressed in due time.

• Authors: Ashima Choudhry, Geunwu Gimm, Ho Won Kang, Chang Ho Shin, Won Joon Yoo, In-Ho Choi, Tae-Joon Cho
• Journal: Journal of pediatric orthopedics. Part B (J Pediatr Orthop B) Vol. 31 Issue 1 Pg. e90-e94 (Jan 01 2022) ISSN: 1473-5865 [Electronic] United States
• PMID: 34848667 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Topics

• Acetabulum (diagnostic imaging, surgery)
• Bone Neoplasms
• Child
• Child, Preschool
• Exostoses, Multiple Hereditary (complications, diagnostic imaging, surgery)
• Hip Dislocation
• Hip Joint (diagnostic imaging, surgery)
• Humans
• Male
• Osteochondroma (diagnostic imaging, surgery)